Healthcare Provider Details

I. General information

NPI: 1437578226
Provider Name (Legal Business Name): MS. MARIA ROCYLIE ROMERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2014
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2-2527 KAUMUALII HWY
KALAHEO HI
96741-8309
US

IV. Provider business mailing address

PO BOX 33
KOLOA HI
96756-0033
US

V. Phone/Fax

Practice location:
  • Phone: 808-332-5580
  • Fax: 808-332-5581
Mailing address:
  • Phone: 808-635-2018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171W00000X
TaxonomyContractor
License Number461483621
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number9220
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: